Lawmakers Debate Obamacare Amid Shutdown

As a government shutdown continues to strain agencies across Washington, Rep. Michael Burgess says he remains resolute when it comes to his opposition to the Affordable Care Act—and his determination to do something about it.

A short-term measure to fund the government, without language to address Obamacare, is a nonstarter, he says.

"I would not support it," the Texas Republican said at the National Journal Countdown to Transformation event Thursday. "I can't speak for the Republican conference."

"There was a procedural vote yesterday and everyone stuck to party sides," Burgess said. "This was an opportunity [to reopen the government] and it didn't happen, after 48 hours of the shutdown."

Burgess and Rep. Rosa DeLauro, D-Conn., offered a kind of point-counterpoint on the Affordable Care Act, and the shutdown dominated much of the conversation. Yet neither could offer a clear way to resolve differences over the health care law and funding the government.

ADVERTISEMENT

While Burgess said it is feasible the approach will be to continue passing separate appropriations bills "every 45 minutes until they pile up and the Senate has to pass something," the Senate has rejected that strategy and DeLauro was highly critical of the piecemeal approach.

"Is it conceivable that this is a way to fund the parts of government [Republicans] like, and not fund the parts they don't like?" she said.

She noted that there has been debate over funding parks, veterans' programs, and the National Institutes of Health, while Head Start and nutrition programs have been left out of the mix. "I think it's taking [Republicans] down an electoral path that is a disaster," she said.

Burgess and DeLauro's states are an excellent representation of contrasting approaches to the Affordable Care Act.

Connecticut has opted to set up its own state-based exchange and will expand Medicaid in 2014. The state has embraced efforts to promote the law, with about $6.5 million to be spent on ads and so-called navigators to help people enroll. "The more you educate people, the less fearful they are," she said.

According to DeLauro, there are about 300,000 uninsured people in Connecticut, and the state has had about 400 applicants to the marketplace thus far. "People are excited about the fact that for the first time they'll be able to have insurance they can afford," she said.

Connecticut's exchange also has the fourth-highest premiums in the U.S., though DeLauro said they will try to bring the state's costs down further and was quick to point out that premium costs nationwide are lower than expected.

"The amazing thing is the government can shutdown, but affordable care is launched," she said. "I say yes to that!"

The approach to Obamacare in Texas has been different. The state has declined to set up its own exchange, meaning that a federally run exchange will be the default. Medicaid will not be expanded, though the stakes are arguably higher than in Connecticut. In a state of about 26 million people, roughly 25 percent of Texans are currently uninsured.

"Texas does have a robust safety-net program," Burgess said. "It relies on disproportionate-share funding." He said disproportionate-share hospitals, which serve low-income residents, are concerned about their funding being used to help pay for the Affordable Care Act. Because Texas is not expanding Medicaid, these hospitals will be without a replacement funding source.

Burgess said there is a need for changes in the laws already written, but he emphasized the regulatory burden and the compressed timeline for the Affordable Care Act rollout as problems with the law.

Both lawmakers brought up the rollout of Medicare Part D as evidence to support their position. DeLauro read a series of headlines from when the program first began, to show it too was controversial when it began. Burgess said Obamacare has not followed the example of the Medicare Part D rollout, which he says was better coordinated.

Both lawmakers acknowledged there will be a wait-and-see period to evaluate the law. DeLauro said there would be glitches, but that officials can "work the system to figure out how to best put it into place." Burgess said measuring success would be different, depending on the party.

"There will be a different threshold depending on one's feeling of the law," he said.

With Republicans and Democrats still far apart on a government funding measure, lawmakers said the shutdown could drag on.